A new research study finds that complications during pregnancy can increase the risk of postnatal depression.

Complications during pregnancy can include medical problems such as preeclampsia, deep vein thrombosis, and problems with the baby including poor growth and fetal distress.

Of course, problems during labor may lead to emergency caesarean section.

Dutch researchers looked at 4,941 pregnant women who had enrolled in the Generation R Study, a multiethnic population-based cohort following urban babies in utero through young adulthood.

Information on pregnancy complications was gathered and researchers calculated the risk of postnatal depression for the various complications.

Two months after giving birth, the mothers were assessed for signs of postnatal depression using the Edinburgh scale, a widely used scoring method looking at how the mother is feeling. It ranges from 0, meaning no depression, to 30, meaning very depressed.

Little research had previously been undertaken regarding the association between pregnancy complications and postnatal depression.

The results showed that several pregnancy complications were associated with postnatal depression and the risk of developing depression increased with the number of complications women experienced.

Of the total number who took part in the study, eight percent of women went on to develop postnatal depression. Women who experienced one complication were given an odds ratio of 2.26 for developing postnatal depression and this rose to 5.47 for women who had four or five complications.

The most important risk factors for developing depression included preeclampsia, hospitalization during pregnancy, emergency caesarean section, concern about fetal distress and admission of the baby to special care.

Women who developed depression were more likely to be young, poorly educated and of non-Western origin.

It is estimated around 10 percent of new mothers encounter postnatal depression with most cases developing in the first three months after giving birth.

Depressive symptoms can vary from mild complaints and ‘maternity blues’ to clinically diagnosed postnatal depression. It is often not diagnosed early enough, resulting in women being depressed for longer before they are given effective treatment.

Pauline Jansen, from the Department of Child and Adolescent Psychiatry at Erasmus MC-Sophia and co-author on the paper said: “Our study showed that various complications during pregnancy and delivery are associated with an increased risk of postpartum depression in women 2 months after giving birth.

“Women who experienced more than two perinatal complications are especially at a high risk of developing postpartum depression. These are important findings, particularly given the high prevalence of some of the perinatal complications. Health care practitioners involved in the care for pregnant or postpartum women and their babies should be aware of the substantially increased risk of postpartum depression associated with complicated pregnancies and difficult deliveries. This increased awareness might contribute to quicker diagnosies of postpartum depression.”

The study is published in BJOG: An International Journal of Obstetrics and Gynaecology.

Professor Philip Steer, BJOG editor in chief, said: “The detection and treatment of postnatal depression is an essential part of caring for new mothers and their babies. It is important that health care professionals are aware of the link between complications and postnatal depression and work together to detect depressive symptoms in women. Few studies before this have looked at this area and further research is needed to build on these findings.”